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Wang ZK, Yi JL, Zhang Y, Wu RY, Zhang JH, Wang JB, Chen XS, Wang K, Qu Y, Huang XD, Gao L, Xu GZ, Luo JW. Clinical Characteristics and Long-Term Outcomes following Surgery Combined with Adjuvant Radiotherapy for Patients with Frontal Sinus Malignancies. J Neurol Surg B Skull Base 2023; 84:609-615. [PMID: 37854532 PMCID: PMC10581825 DOI: 10.1055/a-1924-9319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022] Open
Abstract
Objectives Primary frontal sinus malignancies (FSMs) are the rarest sinonasal cancers. This study aimed to determine clinicopathologic characteristics of primary FSMs and provide long-term survival outcomes. Design This study is a retrospective review. Setting The study was conducted at a tertiary medical center. Participants Patients who participated in this study were diagnosed with primary FSMs. Main Outcome Measures Median survival time is the primary outcome measure of this study. Results In this series, the median age was 48 years (30-53 years) and all patients were male. There were five cases with squamous cell carcinoma and one with osteosarcoma. All cases presented with locally advanced disease without regional lymphatic metastasis, including five cases of stage III and one case of stage II. The two most common pathways of tumor invasion were as follows: local tumor broke posteriorly through bone wall and invaded dura mater, followed by frontal lobe; local tumor infiltrated downward through the floor of frontal sinus into ethmoid sinus, thereafter invaded laterally orbit and orbital contents. All patients received surgery followed by postoperative radiotherapy at the total doses of 50 to 75.95 Gy. Among them, only one patient underwent R0 resection, the rest of patients underwent R1/R2 resection. With a median survival time of 56 months (32-76 months), two patients receiving R1/R2 resection developed treatment failure and died within 5 years, including one case with local recurrence and one with local recurrence, thereafter distant metastasis. Conclusion The majority of FSMs presented with peripherally invasive progression lesions which led to a high ratio of R1/R2 resection. Surgery combined with postoperative radiotherapy might result in satisfactory efficacy.
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Affiliation(s)
- Ze-Kun Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun-Lin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Run-Ye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiang-Hu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing-Bo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Song Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Dong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guo-Zhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing-Wei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Al Hatmi AS, Al Ajmi E, Albalushi H, Al Lawati M, Sirasanagandla SR. Anatomical variations of the frontal sinus: A computed tomography-based study. F1000Res 2023; 12:71. [PMID: 37811203 PMCID: PMC10556568 DOI: 10.12688/f1000research.129498.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/10/2023] Open
Abstract
Background: The pneumatization of the frontal sinus is variable between individuals, including monozygotic twins. The volumetric anatomic variants of the frontal sinus are classified into aplasia, hypoplasia, medium-sized, and hyperplasia. We aimed to study the frontal sinus morphology in Omani patients using computed tomography (CT) evaluations. Methods: Retrospectively, 1220 frontal sinus CT scans from 610 patients investigated at Sultan Qaboos University Hospital, Oman, from January 2019 to December 2020 were reviewed. The frontal sinus morphology was classified according to the classification proposed by Guerram et al. The Chi-square test was used to determine the influence of sex. Results: With regard to the unilateral occurrence, the most prevalent frontal sinus category observed was medium-sized (13.3%), followed by hyperplasia (7.9%), hypoplasia (5.4%), and aplasia (2%) categories. Similarly, in bilateral occurrence, the most common frontal sinus category observed was medium-sized (53%), followed by hyperplasia (13.1%), hypoplasia (3.4%) and aplasia (2%) categories. Right and left frontal sinus aplasia were observed in 2.1% and 1.8% of cases, respectively. In terms of sex influence, the left unilateral ( p<0.01) and the bilateral hypoplasia ( p<0.05) were significantly higher in females. On the other hand, the left unilateral ( p<0.01) and the bilateral hyperplasia ( p<0.05) were higher in males. Conclusions: The baseline data of frontal sinus category frequencies reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting. The preoperative recognition of frontal sinus types, particularly frontal sinus aplasia in multiplanar CT scans, is crucial to avoid unexpected complications while performing endoscopic sinus surgery.
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Affiliation(s)
- Asma Sulaiman Al Hatmi
- Department of Radiology, Ibri Hospital, Ibri, 512, Oman
- Department of Radiology and Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Muscat, 123, Oman
| | - Eiman Al Ajmi
- Department of Radiology and Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Muscat, 123, Oman
| | - Halima Albalushi
- Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Al khoudh, Muscat, 123, Oman
| | - Meetham Al Lawati
- College of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Muscat, 123, Oman
| | - Srinivasa Rao Sirasanagandla
- Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Al khoudh, Muscat, 123, Oman
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Howser LA, Jones AJ, Sreenath SB, Ting JY, Illing EA. Frontal Sinus Anatomy Variations in Race and Sex Using the International Frontal Sinus Anatomy Classification. EAR, NOSE & THROAT JOURNAL 2023:1455613231185701. [PMID: 37470260 DOI: 10.1177/01455613231185701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Objective: To identify frontal sinus anatomical variations grouped by patient sex, race, and presence of chronic rhinosinusitis with frontal sinus involvement (CRFS) using the International Frontal Sinus Anatomy Classification (IFAC) system. Methods: A retrospective review from 2015 to 2020 was performed of consecutive adult patients with computed tomography sinus imaging. Prevalence of frontal sinus cells using the IFAC system was recorded. Comparisons were made between patient race, sex, and CRFS groups. Results: A total of 184 patients (368 sides) were included, 90 (48.9%) of which had CRFS. The racial distribution was 50 white (27.2%), 50 black (27.2%), 45 Hispanic/Latino (24.5%), and 39 Asian (21.2%) patients. The supra agger cell was most prevalent in the white population (P = 0.009), and supraorbital ethmoid cells were more prevalent in the Asian population (P = 0.017). Patients with frontal sinus disease were more likely to have a supraorbital ethmoid cell (P = 0.024). Overall, CRFS was more prevalent in the Asian population (P = 0.013). Conclusion: Significant differences in frontal sinus anatomy and disease exist between patient race and sex. Supraorbital ethmoid cells are associated with the development of CRFS. These patterns in frontal sinus anatomy should be noted prior to frontal sinus surgery to improve surgical awareness and outcomes.
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Affiliation(s)
- Lauren A Howser
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alexander J Jones
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Satyan B Sreenath
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jonathan Y Ting
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elisa A Illing
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Catalfamo LM, Scozzaro C, De Rinaldis D, Romeo C, Cicchiello S, Nava C, Squillacioti A, De Ponte FS. The C-S Approach for The Management of Median or Paramedian Frontal Sinus Lesion. Indian J Otolaryngol Head Neck Surg 2022; 74:4598-4602. [PMID: 36742757 PMCID: PMC9895234 DOI: 10.1007/s12070-021-02896-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/26/2021] [Indexed: 02/07/2023] Open
Abstract
The frontal sinus is one the most complex of the paranasal sinuses, its proximity to the cranial vault and the orbit cause that frontal sinus pathologies can progress to involve these structures and lead to significant morbidity, or even death. Surgical management of the frontal sinus is technically challenging, the most commonly used surgical approaches are coronal, butterfly, gullwing and suprabrow. The purpose of this article is to propose the C-S approach, an interesting alternative to the gullwing approach for the managing of median and paramedian frontal sinus lesions or isolated displaced fractures of the anterior wall. The main advantage of this technique is represented by the fact that it follows the new tension lines described in the literature, a curved vertical line that follows the glabellar frown.
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Affiliation(s)
- Luciano Maria Catalfamo
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Calogero Scozzaro
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
- AOU Policlinico “G. Martino”, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Danilo De Rinaldis
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Chiara Romeo
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Samuele Cicchiello
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Carla Nava
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Antonella Squillacioti
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
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Abstract
Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be managed with a combination of open and endoscopic sinus surgery and intravenous antibiotic therapy. In the current report, a 15-year-old male presented with a classic case of Pott's puffy tumor which was managed with bilateral ethmoidectomies, frontal sinusotomies, and frontal sinus trephination, resulting in discharge on intravenous antibiotic therapy and subsequent complete resolution of symptoms.
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Affiliation(s)
- Robert J Tibesar
- 50235Children's Minnesota ENT Facial Plastic Clinic, Minneapolis, MN, USA
| | - Ariel M Azhdam
- 97174Rosalind Franklin University of Medicine and Science, Chicago Medical School, Chicago, IL, USA
| | - Michela Borrelli
- 22494Cedars Sinai Sinus Center of Excellence, Los Angeles, CA, USA.,Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
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6
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Al Yaeesh I, AlOmairin A, Al Shakhs A, Almomen A, Almomen Z, AlBahr A, AlNaim A, Al Abdulgader A, Alawadh A. The serious complications of frontal sinusitis, a case series and literature review. J Surg Case Rep 2020; 2020:rjaa474. [PMID: 33425318 PMCID: PMC7778520 DOI: 10.1093/jscr/rjaa474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 11/14/2022] Open
Abstract
The aim of this study is to illustrate the managements of different clinical and radiological presentations of serious complications of frontal sinusitis diagnosed and managed at the tertiary referral hospital. A case series study conducted at the tertiary referral in the period from 2012 to 2019. Four different cases of serious complications of frontal sinusitis namely orbital abscess, frontal meningitis, subdural empyema and frontal lobe abscess will be presented and discussed. Despite the generous use of antibiotics, the serious complications of frontal sinusitis still develop. The serious complications of frontal sinusitis ranges from orbital abscess to frank frontal lobe abscess. The management is a combination of systemic antibiotics and surgical drainage with excellent outcomes.
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Affiliation(s)
| | | | | | - Ali Almomen
- Correspondence address. Rhinology & Skull Base Surgery, Department of Otorhinolaryngology, King Fahad Specialist Hospital Dammam, Saudi Arabia. Tel.: 00966505843702; E-mail:
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7
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Tejani N, Kshirsagar R, Song B, Liang J. Evolving Treatment of Frontal Sinus Cholesteatoma: A Case Report. Perm J 2020; 24:19.048. [PMID: 32097113 DOI: 10.7812/tpp/19.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cholesteatomas are lined by squamous epithelium, contain keratin debris, and can cause bony erosion. Although commonly found in the middle ear space and mastoid, cholesteatomas may develop in adjacent structures including the paranasal sinuses. Frontal sinus cholesteatoma (FSC) is a rare condition with fewer than 30 reported cases. The aims of this study are to describe the clinical presentation, diagnostic imaging, and endoscopic treatment of FSC and to review the literature focusing on the pathogenesis, diagnosis, and historical and contemporary treatments of FSC. CASE PRESENTATION A 45-year-old man presented with a 1-week history of right eyelid and forehead swelling. Results of computed tomography scans and magnetic resonance images revealed a right frontal sinus lesion of soft-tissue density with bony dehiscence along the superior orbit and posterior table. He underwent right-sided endoscopic sinus surgery at a tertiary care center in January 2017. Intraoperatively, the frontal sinus contained keratin debris suggestive of FSC. This suspicion was confirmed postoperatively by pathologic analysis after subtotal resection. DISCUSSION The pathogenesis of frontal sinus cholesteatoma varies based on its cause (congenital vs acquired). Clinical diagnosis remains challenging but is aided by nasal endoscopy, computed tomography, and magnetic resonance imaging. Historically, FSC has been managed by total extirpation through open approaches, which can entail substantial morbidity. With sophisticated endoscopic sinus instrumentation and image guidance, FSC can be successfully treated via an endoscopic approach. Serial débridements and washouts in an outpatient setting may adequately manage the residual disease in the postoperative period.
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Affiliation(s)
- Nizar Tejani
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport
| | - Rijul Kshirsagar
- Department of Otolaryngology, Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, CA
| | - Brian Song
- Department of Otolaryngology, Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, CA
| | - Jonathan Liang
- Department of Otolaryngology, Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, CA
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8
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Graziani J, Penicaud M, Hazbri D, Dessi P, Michel J, Radulesco T. Transpalpebral Frontal Sinus Septectomy: Feasibility and Results. Am J Rhinol Allergy 2020; 34:375-381. [PMID: 31914320 DOI: 10.1177/1945892419899351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Transpalpebral frontal septectomy (TFS) can be performed for unilateral frontal sinusitis drainage (into the contralateral healthy frontal sinus) or to provide access to the lateral extent of the contralateral frontal sinus. This procedure has demonstrated its usefulness in several problematic situations for the endoscopic surgeon. Objective The main objective of our study was to evaluate the feasibility of TFS. Secondary objectives were to define outcomes, early and late complications, contraindications, and failure rates of the TFS. Methods We reviewed patient demographics including age and gender, indication for frontal septectomy, prior surgeries, failure rates and necessity of revision surgery, early and late complications, and the side of the approach (ipsi- or contralateral to the frontal sinus pathology). Twenty patients who had undergone TFS were included. Patients were classified into 2 groups according to the surgical indication: group 1—TFS performed for unilateral frontal sinusitis to drain a frontal sinus in the contralateral frontal sinus; and group 2—TFS performed to provide access to the lateral extent of the contralateral frontal sinus. Scarring was assessed using the SCAR-Q questionnaire. Results TFS was performed on all patients in Groups 1 and 2 (success rate = 100%). No patients had recurrence of the pathology 6 months after surgery (0%). No patient needed revision surgery (0%). One complication (frontal hypoesthesia) was reported 6 months after surgery. Mean SCAR-Q score was 99.3 ± 2.5 (min = 91/100, max = 100/100). Conclusion TFS was feasible for all patients in this study. This procedure permits drainage of the frontal sinus and gives access to the lateral extent of the contralateral frontal sinus, without visible scarring, and with few lasting complications. Authorization to conduct this study was obtained from the Ethical Committee of our institution (APHM, n°2019_65).
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Affiliation(s)
- Jade Graziani
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France
| | - Martin Penicaud
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France
| | - Djamel Hazbri
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France
| | - Patrick Dessi
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France
| | - Justin Michel
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France.,Centre National de la Recherche Scientifique, Institut Universitaire des Systèmes Thermiques Industriels, Aix-Marseille Université, Marseille, France
| | - Thomas Radulesco
- Department of Otorhinolaryngology-Head and Neck Surgery, Assistance Publique-Hôpitaux de Marseille, La Conception University Hospital, Marseille, France.,Centre National de la Recherche Scientifique, Institut Universitaire des Systèmes Thermiques Industriels, Aix-Marseille Université, Marseille, France
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9
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Kolcun JPG, Richardson AM, Gernsback JE, Rosenberg A, Komotar RJ. Frontal Sinus Osteoma Presenting with Meningitis and Epilepsy. World Neurosurg 2018; 123:216-220. [PMID: 30579023 DOI: 10.1016/j.wneu.2018.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Osteomas are benign lesions of bone, most frequently seen in the paranasal sinuses; however, they are typically asymptomatic and without complication. We report a rare case of large frontal sinus osteoma with intracranial extension, associated with meningitis and the development of seizures. CASE DESCRIPTION The patient is a 38-year-old man with a prolonged history of headache and seizures, who was seen by multiple specialists previously, all of whom deferred treatment. After years of worsening seizure activity, he finally underwent surgical resection of the lesion at our institution in a joint operation with neurosurgery and otolaryngology. We examine his course, presentation, and management, and examine the literature for cases of complicated sinus osteomas. CONCLUSIONS This represents the fourth reported case of frontal sinus osteoma associated with meningitis. We believe this case demonstrates the value of a robust differential and a multidisciplinary approach.
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Affiliation(s)
- John Paul G Kolcun
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
| | - Angela M Richardson
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Joanna E Gernsback
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrew Rosenberg
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Andejani D, Mrad MA. Enlargement of Frontal Sinus, Case Report. Aesthetic Plast Surg 2018; 42:1013-1018. [PMID: 29492672 DOI: 10.1007/s00266-018-1106-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/10/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Frontal sinus enlargement has been classified into hypersinus, pneumosinus dilatans and pneumocele. CASE REPORT A young male presented with aesthetic concerns regarding his forehead swelling. The patient had no functional disturbances. Radiographic assessment proved expansion of the frontal sinus with extreme thinning of the frontal bone. DISCUSSION The causes of frontal sinus expansion have been listed along with a proposed management plan for each type. If blockage is suspected, functional endoscopic sinus surgery can alleviate the blockage. Open surgery is indicated when the element presents as an aesthetic concern. Obliteration of the sinus is indicated with NF obstruction. And reshaping of the anterior table is the mainstay to correct the enlargement. CONCLUSION Frontal sinus enlargement regardless of the cause can be tackled using well known principles. We believe that every plastic surgeon should have a basic understanding of frontal sinus enlargement and its management. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
| | - M Amir Mrad
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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11
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Michel J, Radulesco T, Graziani J, Penicaud M, Dessi P. Transpalpebral approach for frontal sinus diseases: A camouflaged technique. Clin Otolaryngol 2018; 43:1189-1191. [DOI: 10.1111/coa.13090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J. Michel
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery Assistance Publique Hôpitaux de Marseille La Conception University Hospital Marseille France
- Aix Marseille University CNRS IUSTI UMR 7343 13453 Marseille France
| | - T. Radulesco
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery Assistance Publique Hôpitaux de Marseille La Conception University Hospital Marseille France
- Aix Marseille University CNRS IUSTI UMR 7343 13453 Marseille France
| | - J. Graziani
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery Assistance Publique Hôpitaux de Marseille La Conception University Hospital Marseille France
- Aix Marseille University CNRS IUSTI UMR 7343 13453 Marseille France
| | - M. Penicaud
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery Assistance Publique Hôpitaux de Marseille La Conception University Hospital Marseille France
| | - P. Dessi
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery Assistance Publique Hôpitaux de Marseille La Conception University Hospital Marseille France
- Aix Marseille University CNRS IUSTI UMR 7343 13453 Marseille France
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12
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Štoković N, Trkulja V, Čuković-Bagić I, Lauc T, Grgurević L. Anatomical variations of the frontal sinus and its relationship with the orbital cavity. Clin Anat 2017; 31:576-582. [PMID: 29044800 DOI: 10.1002/ca.22999] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/06/2017] [Accepted: 10/13/2017] [Indexed: 11/10/2022]
Abstract
The anatomy of the frontal sinus is highly variable and its variations affect the occurrence/course of pathological processes. We investigated its size and relationship to the orbit, searching for patterns that would allow it to be classified anatomically. Cone beam computed tomography was applied to 91 skulls (age range 21-86 years) to determine sinus height, width, length, and length of contact with the orbit in the coronal and sagittal planes. In addition, orbital roof pneumatization in the coronal plane was categorized as: none; only medial part pneumatized; the medial and a portion of the central part pneumatized; roof predominantly pneumatized. Sinus dimensions varied widely (mm): height 6.2-50.0; width 3.7-54.0; length 2.4-45.0; frontal orbital contact 4.0-41.6; sagittal orbital contact 0.0-41.2. Pneumatization of the orbital roof (coronal plane) mostly affected the medial and a portion of the central part (50%), or the roof was predominantly pneumatized (32%). Three "types" of sinus (cluster analysis) were distinguished by the extent of pneumatization of the orbital roof in the coronal plane: "small", pneumatization absent or only of the medial part; "medium-sized", pneumatization of the medial and a portion of the central part; "large", roof predominantly pneumatized. All dimensions were significantly different among the types (P < 0.001). Sinus type was fairly predictive of the extent of contact with the orbit in the sagittal plane (not routinely assessed clinically). The data confirm the variability of frontal sinus anatomy and suggest a simple and straightforward classification with potential clinical relevance. Clin. Anat. 31:576-582, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Nikola Štoković
- Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Vladimir Trkulja
- Department of Pharmacology, School of Medicine, University of Zagreb, Croatia, Zagreb, 10000, Croatia
| | - Ivana Čuković-Bagić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Croatia, Zagreb, 10000, Croatia.,Department of Dental Medicine, University Hospital Center Zagreb, Croatia, Zagreb, 10000, Croatia
| | - Tomislav Lauc
- Department of Anthropology, Faculty of Social Sciences and Humanities, University of Zagreb, Zagreb, 10000, Croatia.,Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Osijek, Osijek, 31000, Croatia
| | - Lovorka Grgurević
- Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Zagreb, 10000, Croatia
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